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The paper by Gilham et al,1 published in Occupational and Environmental Medicine, is important for a number of methodological and substantive reasons, and contributes novel information on the body of epidemiology evidence on the association between asbestos exposure and subsequent risk of pleural mesothelioma.
The use of lung fibre burden as a method to estimate past asbestos exposure has been advocated for a long time,2 and these authors have, for the first time, applied this approach to their large-scale population study, which has already provided important results on the association between asbestos and mesothelioma, based on conventional epidemiological indicators of exposure, that is, occupational categories and time-related factors.3 The method is not free from possible bias, in particular resulting from the difficulty in obtaining lung tissue samples from unbiased groups of mesothelioma cases and controls. In the study by Gilham et al …
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